RESUMEN
STUDY OBJECTIVE: Evidence-based menstrual health education is not mandated in any U.S. state or territory. Aspects of normal and abnormal menstruation impact quality of life and educational engagement, but many youth are not prepared to know when to seek medical help. We sought to determine which topics should be included in a 3rd through 8th grade school-based menstrual health curriculum. METHODS: We conducted a cross-sectional online survey of medical professionals who care for patients with menstrual problems. We asked participants to indicate the top three menstrual health topics by grade and we compared the most common responses by year. We also solicited general comments about curriculum content. RESULTS: Surveys from 55 medical professionals met criteria for analysis. The most frequent topics to be selected were normal and abnormal menstruation, reproductive anatomy, puberty timeline, and menstrual products. A majority recommended the topics of puberty timeline (38, 69.1%) and reproductive anatomy (34, 61.8%) for 3rd grade, introducing normal menstruation (31, 56.4%) and menstrual products (24, 46.3%) in 4th grade, and abnormal menstruation (27, 49.1%) in 6th grade. More complex topics such as world cultures around menstruation (14, 25.5%) and period poverty (11, 20.0%) were preferred for 8th grade. Many providers emphasized the importance of teaching normal versus abnormal menstruation in a school health curriculum. CONCLUSION: Medical professionals provide recommendations for a school-based menstrual health curriculum that introduces topics at developmentally appropriate ages from a medical perspective, teaches basic menstrual symptom management, and instructs on warning signs for abnormal menstruation.
RESUMEN
STUDY OBJECTIVE: To compare menstrual health literacy among adolescents and young adults on the basis of family religious background and United States region METHODS: We conducted a cross-sectional online survey of post-menarcheal US adolescents and young adults aged 14-24 years who identified their family religious background, including Christian or non-religious, with recruitment via the social media platform TikTok. We asked participants several questions to assess their health literacy regarding common myths about the use of gonadal steroid hormones for menstrual suppression. RESULTS: From 3250 online survey respondents, 2997 met the criteria for analysis, with 1989 identifying their family as Christian (66.4%) and 1008 identifying their family as non-religious (33.6%), with equal representation by US region. Health literacy was lower among those with a Christian family background, with concerns that menstrual suppression is unhealthy (16.4% vs 10.5% with non-religious background, P < .01), is unsafe (31.4% vs 24.2%, P < .01), and could lead to infertility (32.6% vs 20.0%, P < .01). Similarly, adolescents and young adults from the US South were worried that menstrual suppression is unhealthy (31.5%; P < .01) and would lead to infertility (33.8%; P < .01). CONCLUSION: Health literacy is lower among adolescents and young adults with a Christian family background and those who live in the South. These results demonstrate a need for an evidence-based national curriculum that addresses the safe and effective use of hormonal medications for menstrual suppression.